Issues of systemic and topical antibiotic therapy of acute rhinosinusitis in a child

Abstract

This article discusses the use of antibacterial therapy in the treatment of acute rhinosinusitis in children. The main problems causing the need for maximum rationalization of the use of systemic antibiotics in the treatment of respiratory pathology are listed. Indications for systemic and topical antibacterial therapy for acute rhinosinusitis in children indicated in Russian clinical guidelines were noted. The possibilities of using the combined drug thiamphenicol and N-acetylcysteine in the treatment of acute rhinosinusitis in children are considered separately. As an example, a model of the clinical situation at the outpatient stage of treatment, in which the use of inhalation therapy is advisable, is given. It is concluded that inhalation therapy with a combination drug of thiamphenicol and N-acetylcysteine in the treatment of acute rhinosinusitis is a reasonable choice in case the doctor doubts the need for systemic antibacterial therapy. Taking into account the high frequency of such situations in the practice of a pediatrician and a pediatric otorhinolaryngologist, the decision in favor of topical antibacterial therapy carries significantly less costs compared to the decision to prescribe systemic antibacterial therapy. But an obligatory element of the therapeutic tactics of acute rhinosinusitis with the use of topical antibacterial drugs should be monitoring the dynamics of the patient's condition during 3-4 days of therapy. In the absence of positive changes, the doctor is obliged to reconsider the need for systemic antibacterial therapy.